What Is Haglund's Deformity?
Haglund’s deformity is a bony enlargement on the back of the heel. The soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes. This often leads to painful bursitis, which is an inflammation of the bursa (a fluid-filled sac between the tendon and bone).
What Causes Haglund's Deformity?
Haglund’s deformity is often called “pump bump” because the rigid backs of pump-style shoes can create pressure that aggravates the enlargement when walking. In fact, any shoes with a rigid back, such as ice skates, men’s dress shoes, or women’s pumps, can cause this irritation.
To some extent, heredity plays a role in Haglund’s deformity. Inherited foot structures that can make one prone to developing this condition include:
- A high-arched foot
- A tight Achilles tendon
- A tendency to walk on the outside of the heel
Symptoms to Look Out For
Haglund’s deformity can occur in one or both feet. The symptoms include:
- A noticeable bump on the back of the heel
- Pain in the area where the Achilles tendon attaches to the heel
- Swelling in the back of the heel
- Redness near the inflamed tissue
How Is Haglund's Deformity Diagnosed?
After evaluating the patient’s symptoms, Ozan Amir will examine the foot. In addition, x-rays will be ordered.
Conservative Treatment Options
Non-surgical treatment of Haglund’s deformity is aimed at reducing the inflammation of the bursa. While these approaches can resolve the pain and inflammation, they will not shrink the bony protrusion. Non-surgical treatment can include one or more of the following:
| Approach | What it does |
|---|---|
| Medication | Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce the pain and inflammation. |
| Ice | To reduce swelling, apply an ice pack to the inflamed area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again. |
| Exercises | Stretching exercises help relieve tension from the Achilles tendon. These exercises are especially important for the patient who has a tight heel cord. |
| Heel lifts | Patients with high arches may find that heel lifts placed inside the shoe decrease the pressure on the heel. |
| Heel pads | Pads placed inside the shoe cushion the heel and may help reduce irritation when walking. |
| Shoe modification | Backless or soft backed shoes help avoid or minimise irritation. |
| Physical therapy | Physical therapy modalities, such as ultrasound, can help to reduce inflammation. |
| Orthotic devices | Custom arch supports control the motion in the foot. |
| Immobilisation | In some cases, casting may be necessary. |
When Symptoms Persist
If non-surgical treatment fails to provide adequate pain relief, surgery may be needed. Ozan will determine the procedure that is best suited to your case.
Haglund's Deformity in Children and Teenagers
Pain at the back of the heel in a child between roughly eight and fourteen years of age is more often calcaneal apophysitis, also known as Sever’s disease, an irritation of the growth plate where the Achilles tendon attaches. It is a different condition from Haglund’s deformity and is assessed on its own terms, which is why heel pain in a growing child is examined rather than assumed.
Haglund's Deformity FAQs
Haglund’s deformity is often called “pump bump” because the rigid backs of pump-style shoes can create pressure that aggravates the enlargement when walking. In fact, any shoes with a rigid back, such as ice skates, men’s dress shoes, or women’s pumps, can cause this irritation.
Non-surgical treatment of Haglund’s deformity is aimed at reducing the inflammation of the bursa. While these approaches can resolve the pain and inflammation, they will not shrink the bony protrusion.
Backless or soft backed shoes help avoid or minimise irritation. Pads placed inside the shoe cushion the heel and may help reduce irritation when walking.
If non-surgical treatment fails to provide adequate pain relief, surgery may be needed. Ozan will determine the procedure that is best suited to your case.
No, you can book directly without a referral. If you’d like, we’ll send a short report to your GP after your appointment so your foot care stays part of your overall health record. If your appointment is through a Medicare care plan, DVA or another funded program, you will need a referral, so check with us when you book.
Serving Manly and the Northern Beaches.
Manly Foot Clinic is at Shop 3/3 Corrie Rd, North Manly, NSW 2100, and treats Haglund’s deformity for patients from Manly, Dee Why, Brookvale, Freshwater and Balgowlah. The clinic is open Monday to Friday from 8:30am to 5:30pm and Saturday from 8:00am to 2:00pm.